DOI: 10.1093/bjs/znad258.729 ISSN:

728 A Comparison of mpMRI and Template Biopsy in the Prediction of Clinically Significant Prostate Cancer at Final Radical Prostatectomy Pathology

W Ong, A Bates, G Nabi
  • Surgery



Diagnosis and precise risk stratification of prostate cancer (PCa) is essential for individualized treatment decisions.


This single-centred retrospective study included consecutive patients undergoing elective RP due to PCa with prior mpMRI and TPMBs biopsy between 2017-2022. We evaluated the value of PI-RAD v2 score, Gleason score (GS) and TPMB cores against RP specimens to determine its efficacy in identifying csPCa i.e Gleason score ≥3+4, or any cancer >6mm in size.


A total of 49 patients were included. Mean age was 70 years (IQR 67-75) and PSA 11.7 ng/ml (IQR 6.4-13.6). For PI-RAD ≥ 3, 86% (42/49) vs 96% (47/49) had csPCa on TPMB and RP respectively. No statistically significant association was found between PI-RAD v2 score and GS of TPMB or RP (p = 0.9). When comparing the cumulative GS of TPMB versus RP (p<0.001), 49% (n = 24) had identical scores, 29% (n = 14) were downgraded, 22% (n = 11) were upgraded. For upgrading, 6/11 (55%) were PI-RAD 5 lesions. Only 2/11 (18%) and 3/11 (27%) constituted of PI-RAD 3 & 4 respectively.


There is no correlation between the PI-RAD v2 scoring system and final histopathology of RP specimens, and a low proportion of PI-RAD 3 or 4 lesions are upgraded at final pathology.

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